Japanese Society for Infection Prevention and Control-Online Journal

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Article in Japanese

Management of Candidemia

Issei TOKIMATSU
Department of Medicine, Clinical Infectious Diseases, School of Medicine, Showa University

Candidemia occurs frequently in bacteremia and has a high mortality rate. This disease requires appropriate diagnosis and treatment.
The bundle for candidiasis in Japanese guidelines proposed the following: collecting two sets of blood cultures, measuring β-glucan in suspected cases, removing the central venous catheter within 24 h, starting appropriate initial treatment, checking for the presence or absence of ocular lesions, administration of antifungals for at least two weeks after negative blood culture, and confirmation of candidiasis symptom improvement. It was reported that good prognosis was shown by observing these. Antifungal stewardship that should be practiced for candidemia is required with ophthalmic examination at the early diagnostic stage of candidemia and one week after the detection of candidemia, intervention about appropriate early treatment at the time of positive blood culture of yeast-like fungi, and proposal of step-down treatment for patients with long-term treatment and stable symptoms.
This article describes basic information about the bundle and guidelines for candidemia, and candidemia management from a multiprofessional perspective.

Key words：candidemia, ocular candidiasis, central venous catheter, bundle, antifungal stewardship team

e-mail: issei＠med.showa-u.ac.jp

Received: August 6, 2019
Accepted: October 3, 2019

35 (1)：1─6,2020